Provider Demographics
NPI:1104811520
Name:BRIGHT, DEBRA LEE (FNP)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:LEE
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 LAYMANTOWN RD
Mailing Address - Street 2:P. O. BOX 200, BLUE RIDGE, VA. 24064
Mailing Address - City:TROUTVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24175-6635
Mailing Address - Country:US
Mailing Address - Phone:540-977-1436
Mailing Address - Fax:540-977-4230
Practice Address - Street 1:37 LAYMANTOWN RD
Practice Address - Street 2:
Practice Address - City:TROUTVILLE
Practice Address - State:VA
Practice Address - Zip Code:24175-6635
Practice Address - Country:US
Practice Address - Phone:540-977-1436
Practice Address - Fax:540-977-4230
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024164903363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010389861Medicaid
VAP00387201OtherMEDICARE RAILROAD
VAP00387201OtherMEDICARE RAILROAD
P99528Medicare UPIN
VA010389861Medicaid